Roopinder K Sandhu1, Robert S Sheldon2, Anamaria Savu3, Padma Kaul4. 1. Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada. Electronic address: rsandhu2@ualberta.ca. 2. Division of Cardiology, University of Calgary, Calgary, Alberta, Canada. 3. Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada. 4. Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
Abstract
BACKGROUND: We examined the prevalence, comorbidity burden, and outcomes of patients who presented to acute care hospitals with a primary diagnosis of syncope over a 10-year period in Canada. METHODS: The Canadian Institute for Health Information Discharge Abstract Database (which contains detailed health information from all Canadian provinces and territories except Quebec) was used to identify hospitalizations of patients with a primary diagnosis of syncope (International Classification of Diseases-10th Revision code R55) 20 years of age or older in Canada from 2004 to 2014. Annual age- and sex-standardized hospital discharge rates were calculated. Logistic regression was used to examine patient factors associated with in-hospital mortality, 30-day readmission for any cause, and syncope. RESULTS: During the 10-year study period, 98,730 hospitalizations occurred for syncope. The age- and sex-standardized hospitalization rate was 0.54 per 1000 population and decreased over time (P < 0.0001). Most patients (63%) were low-risk (Charlson comorbidity index = 0), although the proportion of patients with a Charlson comorbidity index ≥ 3 increased over time. Less than 1% of patients died in-hospital; however, among patients discharged alive, 30-day readmission rates for syncope and any cause were 1.1% and 9.0%, respectively. In-hospital mortality increased with each decade in age (odd ratio, 1.63; 95% confidence interval, 1.48-1.79), was higher in men (odds ratio, 1.37; 95% confidence interval, 1.16-1.63), and in patients with greater comorbidity (P < .0001). CONCLUSIONS: The hospitalization rate for syncope is decreasing over time in Canada. Although the comorbidity burden of hospitalized patients is increasing, most syncope patients are low-risk. Future studies are needed to help understand how standardized diagnostic testing pathways and discharge planning might lead to more efficient and cost-effective syncope management.
BACKGROUND: We examined the prevalence, comorbidity burden, and outcomes of patients who presented to acute care hospitals with a primary diagnosis of syncope over a 10-year period in Canada. METHODS: The Canadian Institute for Health Information Discharge Abstract Database (which contains detailed health information from all Canadian provinces and territories except Quebec) was used to identify hospitalizations of patients with a primary diagnosis of syncope (International Classification of Diseases-10th Revision code R55) 20 years of age or older in Canada from 2004 to 2014. Annual age- and sex-standardized hospital discharge rates were calculated. Logistic regression was used to examine patient factors associated with in-hospital mortality, 30-day readmission for any cause, and syncope. RESULTS: During the 10-year study period, 98,730 hospitalizations occurred for syncope. The age- and sex-standardized hospitalization rate was 0.54 per 1000 population and decreased over time (P < 0.0001). Most patients (63%) were low-risk (Charlson comorbidity index = 0), although the proportion of patients with a Charlson comorbidity index ≥ 3 increased over time. Less than 1% of patients died in-hospital; however, among patients discharged alive, 30-day readmission rates for syncope and any cause were 1.1% and 9.0%, respectively. In-hospital mortality increased with each decade in age (odd ratio, 1.63; 95% confidence interval, 1.48-1.79), was higher in men (odds ratio, 1.37; 95% confidence interval, 1.16-1.63), and in patients with greater comorbidity (P < .0001). CONCLUSIONS: The hospitalization rate for syncope is decreasing over time in Canada. Although the comorbidity burden of hospitalized patients is increasing, most syncopepatients are low-risk. Future studies are needed to help understand how standardized diagnostic testing pathways and discharge planning might lead to more efficient and cost-effective syncope management.
Authors: Franca Barbic; Franca Dipaola; Giovanni Casazza; Marta Borella; Maura Minonzio; Monica Solbiati; Satish R Raj; Robert Sheldon; James Quinn; Giorgio Costantino; Raffaello Furlan Journal: J Clin Med Date: 2019-01-29 Impact factor: 4.241
Authors: Safia Chatur; Sunjidatul Islam; Linn E Moore; Roopinder K Sandhu; Robert S Sheldon; Padma Kaul Journal: J Am Heart Assoc Date: 2019-05-21 Impact factor: 5.501
Authors: Amer N Kadri; Hasan Abuamsha; Leen Nusairat; Nazih Kadri; Hussam Abuissa; Ahmad Masri; Adrian V Hernandez Journal: J Am Heart Assoc Date: 2018-09-18 Impact factor: 5.501